by Di Simplot | Sep, 2026 | news, Thought Leadership
Clinical Pathways have always been about a straightforward but difficult goal: Delivering the best possible care while directing limited clinical resources where they can do the most good. That goal has not changed – but the conditions around it have. Rising costs,...
by Di Simplot | Aug, 2026 | news, Thought Leadership
Surging employer health care costs are driving an ever increasing migration away from traditional fully insured plans. Corporate budgets are facing breaking points with healthcare expense climbing 8-9% annually, pushing the average cost per employee past $17,000....
by Di Simplot | Jul, 2026 | news, Thought Leadership
Traditional employer-sponsored healthcare has historically functioned under a reactive, fragmented model, treating clinical illness and employee wellness as separate operational domains. Driven by compounding macroeconomic pressures, growing demands related to chronic...
by Di Simplot | Jun, 2026 | news, Thought Leadership
Pharmacy costs are no longer a background trend for pharmacy benefit managers (PBMs) and/or employers (“Plan Sponsors”)—they are an immediate call to action that centers around benefit design considerations. With health care costs projected to rise by 9% in 2026 and...
by Di Simplot | May, 2026 | news, Thought Leadership
Utilization Management (UM), traditionally viewed as a reactive, administrative cost-containment tool, is undergoing transformation. In the modern, high-stakes healthcare environment, UM has evolved into a strategic, data-driven enterprise control function. It now...
by Di Simplot | Apr, 2026 | news, Thought Leadership
Healthcare payment integrity is undergoing a fundamental transformation as we enter 2026. The healthcare industry is moving away from the traditional and more reactive “pay-and-chase” model toward a more proactive approach centered around the concept...
